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首页> 外文期刊>Journal of substance abuse treatment >Why aren't physicians prescribing more buprenorphine?
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Why aren't physicians prescribing more buprenorphine?

机译：为什么医生不规定更多的Buprenorphine？

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Abstract Background & objective Buprenorphine is an underutilized pharmacotherapy that can play a key role in combating the opioid epidemic. Individuals with opioid use disorder (OUD) often struggle to find physicians that prescribe buprenorphine. Many physicians do not have the waiver to prescribe buprenorphine, and a large proportion of physicians that are waivered do not prescribe to capacity. This study aimed to quantitatively understand why physicians do not utilize buprenorphine for the treatment of OUD more frequently. Methods Physicians ( n = 558) with and without the waiver to prescribe buprenorphine were surveyed about perceived drawbacks associated with prescribing buprenorphine. Furthermore, resources were identified that would encourage those without the waiver to obtain it, and those with the waiver to accept more new patients. The survey was distributed online to physicians in the spring/summer of 2016 via the American Society for Addiction Medicine and American Medical Association listservs. Results and conclusions A logistic regression analysis was used to identify reasons that respondents indicated no willingness to increase prescribing ( χ 2 (4) = 73.18, p 0.001); main reasons were lack of belief in agonist treatment (OR 3.98, 95% CI, 1.43 to 11.1, p = 0.008), lack of time for additional patients (OR 5.54, 95% CI, 3.5 to 8.7, p 0.001), and belief that reimbursement rates are insufficient (OR 2.50, 95% CI, 1.3 to 4.8, p = 0.006). Differences between non-waivered and waivered physicians concerning attitudes toward buprenorphine treatment as well as resources that would increase willingness to prescribe are also discussed. Identifying barriers to buprenorphine utilization is crucial in expanding treatment options for individuals with OUD. Highlights ? Waivered/non-waivered physicians were surveyed re attitudes toward buprenorphine. ? Waivered physicians reported that they did not have time for more patients (36%). ? Many waivered physicians were not interested in prescribing to more patients (55%). ? Non-waivered were concerned about too many requests for buprenorphine (30%). ? Non-waivered were also concerned about diversion of buprenorphine (26%).
机译：抽象背景＆amp;目标丁丙诺啡是一种未充分利用的药物治疗，可以在对抗阿片类疫情方面发挥关键作用。具有阿片类药物使用障碍（Oud）的个体往往努力寻找培养丁丙诺啡的医生。许多医生没有豁免规定Buprenorphine，并且减少的大部分医师不规定能力。本研究旨在定量地理解为什么医生不利用Buprenorphine更频繁地治疗oud。方法对与处方与处方丁丙诺啡相关的感知缺点进行调查，有没有豁免的医生（n = 558）进行调查。此外，确定了资源，这将鼓励那些没有豁免的人获得它，以及豁免接受更多新患者的人。该调查在2016年春季/夏季通过美国成瘾医学和美国医学会Listservs分发给医生。结果和结论使用逻辑回归分析来确定受访者表示不愿意增加处方的意愿（χ2（4）= 73.18，P <0.001）;主要原因是缺乏激动剂处理的信念（或3.98,95％CI，1.43至11.1，p = 0.008），额外患者的时间缺乏时间（或5.54,95％CI，3.5至8.7，P <0.001），并相信报销率不足（或2.50,95％CI，1.3至4.8，P = 0.006）。还讨论了对Buprenorphine待遇态度的非免除和放弃医生的差异以及将增加提高规定意愿的资源。鉴定Buprenorphine利用的障碍对于扩大ouds的个体的治疗方案至关重要。强调 ？被豁免/不放弃的医生对Buprenorphine进行了调查态度。还放弃的医生报告说他们没有时间更多患者（36％）。还许多被豁免的医生对规定更多患者并不感兴趣（55％）。还不放弃担心丁丙诺啡的许多要求（30％）。还不放弃也关注丁丙诺啡的转移（26％）。

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